Field
The disclosure relates generally to the field of medical instrument supports, and more specifically to repositionable medical instrument support systems, devices, and methods.
Description
Laparoscopic gynecological surgery can be performed as traditional straight stick surgery or robotic surgery. Laparoscopic straight stick surgery usually requires a pelvic assistant to hold a uterine manipulator and manipulate the uterus on command of the surgeon, and an assistant to hold a laparoscopic camera for a surgeon to view the abdominal and pelvic contents. The pelvic assistant sits between the legs of the patient who is in a lithotomy position with a monitor screen placed behind the assistant for the surgeon to see the pelvic contents. The only way the assistant can get a view is to turn his or her head to see the screen, or by providing a slave screen which is placed at a head end of the patient. However, the head end area is often occupied by anesthetics screens and overhead theatre lights, so the pelvic assistant has to resort to head turns for vision.
With the advent of the da Vinci robot in gynecological surgery, the pelvic assistant is still required to sit between the legs of the patient and manipulate the uterine manipulator. However, the assistant is at risk of being hit by an articulated arm of laparoscopic instruments which are controlled by the surgeon. In robotic surgery, there is also an abdominal assistant who has a laparoscopic port to manipulate a laparoscopic instrument such as a sucker or to introduce suture material. The laparoscopic camera is held by one arm of the da Vinci robot.
The pelvic assistant at both the straight stick and robotic surgery is subject to tedious and occupational health and safety issues associated with the operating session. Due to human fatigue and boredom, the pelvic platform that is manipulated for the surgery may not be a stable one, leading to frustration by both parties. Utilizing assistants to hold and/or reposition instruments, such as a uterine manipulator also has other risks. For example, a surgeon must relay instructions to the assistant, which creates a risk that the assistant may not fully understand the instructions and may move the instrument in a way different than the surgeon intended.